The Clinical And Mechanism Study On Tongxin Plaster At Acupoint Application On Angina Cordis

ObjectiveCoronary heart disease(CHD)is one of the principal disease nowadays that severely threatening the healthy of mankind.Carry Out the deeply prevention and cure of CHD is a main urgent mission of the medical and health workers.In this article we use the random and control method for this clinical research.To observe the effectiveness of Tongxin Plaster on improving the clinical symptoms of CHD,relieving the degree of angina cordis and seizure frequency,Improving the ischemic condition of electrocardiogram(ECG), antagonizing inflammatory response of coronary artery,inhibiting the activation of platelets,degrading the level of homocysteine(HCY).Method128 CHD patients were randomly divided into four groups.32 cases in experiment group were given acupoint application of "Tongxin Plaster" on acupoint Tanzhong(CV 17)and Xinshu(BL 15)12 hours a day.32 cases in control group A were given foundation treatment,32 cases in control group B were given orally "Shexiangbaoxin Pill",2 pills(45mg)twice a day.32 cases in control group C were given" Tongxin Plaster" applicate on none acupoint(3 cun away by the side from Riyue acupoint),there are no meridian circulate and no acupoint distribute,applicate the left and right each 12 hours a day.The treatment courses of the four groups lasted 3 weeks. All the cases were given the same foundation treatment:①breviscapine ampul 0.1g add in 0.9%sodium chloride 250ml,intravenous transfusion once a day.②ChuanQing injection 0.24g add in 0.9%sodium chloride 250ml,intravenous transfusion once a day.③orally Chinese medicinal broth 200ml twice a day.All the cases were given 3 weeks of treatment and the same food and drink.Before and after 3 weeks of treatment,The sings and symptoms,the adverse effect and the Serum levels of M-CSF,HCY,Hs-CRP,IL-18 and GMP-140 were observed and detected respectively.Detection method:IL-18,M-CSF,GMP-140,HCY use enzyme linked immunosorbent assay(ELISA),hs-CRP use solid phase and chemiluminescence immunization,statistical analysis use SPSS15.0 for windows.ResultsAfter 3 weeks of treatment,the results below:1.The clinical curative effect:The experiment group compare with the control group B(P＞0.05),there was no significant difference.the experiment group compare with the control group C(P＜0.05),there were significant difference.The control group B compare with the control group C(P＜0.05),there were significant difference.2.The curative effect in clinical symptom of traditional Chinese medicine(TCM)(The integral calculus in clinical symptom of TCM):The experiment group compare with the control group B(P＞0.05),there was no significant difference.the experiment group compare with the control group C(P＜0.05),there were significant difference.The control group B compare with the control group C(P＜0.05),there were significant difference.3.The condition of angina pectoris attacks:The experiment group compare with the control group B(P＞0.05),there was no significant difference.the experiment group compare with the control group C(P＜0.01),there were highly significant difference. The control group B compare with the control group C(P＜0.05),there were significant difference.4.The curative effect of electrocardiogram(ECG):The experiment group compare with the control group B(P＞0.05),there was no significant difference.the experiment group compare with the control group C(P＜0.05),there were significant difference.The control group B compare with the control group C(P＜0.05),there were significant difference.5.The changes comparison on the level of IL-18:The experiment group compare with the control group B(P＞0.05),there was no significant,difference.the experiment group compare with the control group C(P＜0.05),there were significant difference.The control group B compare with the control group C(P＜0.01),there were highly significant difference.6.The changes comparison on the level of M-CSF:The experiment group compare with the control group B(P＞0.05),there was no significant difference.the experiment group compare with the control group C(P＜0.05),there were significant difference.The control group B compare with the control group C(P＜0.05),there were significant difference.7.The changes comparison on the level of hs-CRP:The experiment group compare with the control group B(P＜0.05),there were significant difference.the experiment group compare with the control group C(P＜0.001),there were highly significant difference.The control group B compare with the control group C(P＜0.05),there were significant difference.8.The changes comparison on the level of GMP-140:The experiment group compare with the control group B(P＞0.05),there was no significant difference.the experiment group compare with the control group C(P＜0.05),there were significant difference.The control group B compare with the control group C(P＜0.05),there were significant difference.9.The changes comparison on the level of HCY:The experiment group compare with the control group B(P＞0.05),there was no significant difference.the experiment group compare with the control group C(P＜0.001),there were highly significant difference.The control group B compare with the control group C(P＜0.05),there were significant difference. After 3 weeks of treatment,all the above items each changes compare to the pretherapy:The experiment group(P＜0.01～P＜0.001),the control group B(P＜0.001),there were highly significant difference,the control group C(P＜0.05),there were significant difference.10.The safe monitoring:All the patients in each group have no obviously adverse effects after treatment,before treatment and after 3 weeks of treatment,the blood routine,the urine routine,the stool routine,liver function and the renal function have no obviously changes.There were 2 cases in experiment group have lightly itch of skin(of the total one cases were hypersusceptibility body constitution),there were no rashes and skin damages.They can insist on continuentur remedia,the rashes had diSappeared after 3 weeks when the drug withdrawal.In this research,the medicine safety evaluation of "Tongxin Plaster" is II grade. ConclusionThis random and contrast clinical research indicate:"Tongxin Plaster" has good effects on improving the clinical symptoms of CHD,relieving the degree of angina cordis and seizure frequency,improving the ischemic condition of electrocardiogram(ECG), antagonizing inflammatory response of coronary artery,inhibiting the activation of platelets,degrading the level of homocysteine(HCY).which may be one of the mechanism for "Tongxin Plaster" on therapy of CHD.The rapeutic effectes on acupoint application of "Tongxin Plaster" on acupoint Tanzhong(CV 17)and Xinshu(BL 15)are outstriper than on none acupoint.Some effects such as on degrading the level of hs-CRP,"Tongxin Plaster" are superior to "Shexiangbaoxin Pill".Some effects such as on improving the clinical symptoms of CHD,relieving the degree of angina cordis and seizure frequency,improving the ischemic condition of electrocardiogram(ECG),antagonizing inflammatory response of coronary artery, inhibiting the activation of platelets,degrading the level of homocysteine(HCY),ect, "Tongxin Plaster" are equal to "Shexiangbaoxin Pill".Discussion1.The TCM mechanism of action in "Tongxin Plaster" on therapy CHD.(1)Coincide with pathogenesisCHD belong to thoracic obstruction,cardiodynia category in TCM.The pathogenesis is deficient in healthy energy,phlegm,stagnant blood,stagnant of Qi,cold coagulation, pyretic stagnation,ect,stagnating heart meridian,the heart loss of nutrition.Although thoracic obstruction is a asthenia in origin and asthenia in superficiality disease,include with asthenia and sthenia,but deficiency in origin is its fundamental.Thoracic obstruction mostly occurrenced in the middle and aged people,and after age critique woman.Most of the thoracic obstruction patients have renal deficiency clinical manifestation.Because of the long time's kidney-Qi deficience,induce the kidney-Yang deficience.The kidney-Yang deficience can't warm the heart-Yang and spleen-Yang,the gasification and warm functions lost,lead to the phlegm and stagnant blood endogeny and stagnating heart meridian,kidney-Yang deficience and stagnating the vessel in the heart are the fundamental pathogenesis links of thoracic obstruction,"Tongxin Plaster" are manufactured by this pathogenesis.(2)Congenial with prescription and syndromeThe medicine compose of "Tongxin Plaster" are Asiasarum 20g,Prepared Commonot 15g,Cinnamon 15g,chuanxiong 20g,psoralea fruits 15g,borneol 0.05g. Therapeutical principle:warming Yang and invigorate the kidney,removing phlegm and promoting blood flow.Indication:thoracic obstruction(kidney-Yang deficience and stagnating the vessel in the heart).Effectiveness:Prepared Commonot can warm spleen and kidney,Eliminating stagnation to activate Yang.Cinnamon and psoralea fruits can warm kidney and assist Yang,guard the ministerial fre.Asiasarum can expel cold and phlegm. Chuanxiong can promoting blood flow and promoting Qi circulation to relieve pain. Borneol have fragrance and flee walk peculiarity,it can guide other medicines ascend.All the medicines cooperation,then it has a removing phlegm and promoting blood flow function.2.The external treatment mechanism of action in "Tongxin Plaster" Oh therapy CHDThis clinical research choose acupoint Tanzhong and Xinshu application, acupoint Tanzhong located the Ren Channel,it is the converging acupoints of Qi and the enlist acupoints of pericardium meridian.Acupoint Tanzhong is the surrounding of heart, it take the place of heart to exercise order.Acupoint Xinshu is a Beishu acupoint,it is the heart-energy transfusion position,acupoint Xinshu come to the heart's aid,therapy many heart diseases.Acupoint Tanzhong and acupoint Xinshu one at the front and one at the back of heart,one is belong to Yin and one is belong to Yang,Shu and Mu match each other,deoppilation the meridian,regulation Qi and smoothly the spleen and stomach,they are the main acupoints in therapy heart diseases.The medicine absorptive action by penetrate skin,stimulating acupoint,conduction function of meridian,this three process are the main aspects of "Tongxin Plaster" to get it's therapeutical effects.Acupoints are the Qi and blood converge place of entrails,it has a store and amplified action for medicine.When the.medicine oabsorbed by acupoint,the therapeutical effects are not the simple superpositi0n only by the medicine absorptive action by penetrate skin and stimulating acupoint,but also the suscitation each other and coordinate each other,accordingly bring about a entirety effect.Compared with the merely use medicine it can get a better therapeutical effects.This research show some clinical therapeutical effects in treatment group are superior to the orally "Shexiangbaoxin Pill",this is a good illustration,in addition,the therapeutical effects in acupoint application of "Tongxin Plaster" is superior to the application on none acupoint.The possible reason is the therapeutical effects in none acupoint application only by medicine absorped via penetrate skin,but the acupoint application besides this therapeutical effects, the stimulating acupoint function and conduction function of meridian educeda especial considerable therapeutical effects.